Lack of Resources Faulted for Rarity of Randomized Surgical Trials

General Surgery News: 11/22/12

It’s one of the most common conclusions of studies in the surgical literature: The issue at hand should be evaluated by a randomized controlled trial.

But randomized controlled trials (RCTs) rarely happen in surgery. Now, a new report argues that these trials don’t come to fruition because the organization and support to help trialists plan and carry them out is lacking.

In a study published in the September issue of the American Journal of Surgery, researchers from Houston’s Methodist Hospital show that the processes in place to help surgical clinical trialists are haphazard and inefficient, failings that likely contribute to the low numbers of RCTs in surgery (2012;204:339-346.e5).

“Our findings show a remarkably unsystematic process by which highly motivated individuals struggled to find the information and resources necessary to develop competence as trialists and to mount scientifically and ethically sound surgical trials,” concluded lead author Anna F. Jarman, BA, then a graduate student at The Methodist Hospital, and colleagues.

That lack of support and resources translates into a poor showing for surgeons in clinical trials, said the researchers. Only 7.6% of studies evaluating surgical procedures use a comparative clinical trial design, according to another study published online this summer in the Journal of the American College of Surgeons (2012 [Epub ahead of print]). Read more